TREATMENT OF PHALANGEAL AND METACARPAL FRACTURES WITH K-WIRE

Background: Phalangeal and metacarpal fractures are the most common skeletal injuries. Most of these fractures which are reducible and stable can be treated by non-operative methods like casts, splints or braces. However some fractures which are irreducible and unstable require open or closed reduction and fixation. The aim of this study was to evaluate the effectiveness of k-wire fixation in phalangeal and metacarpal fractures with minimal dorsal incision. Material & Methods: This descriptive study was conducted in Orthopedic Unit, DHQ Teaching Hospital D.I. Khan, Pakistan on 54 patients treated with k-wires through a minimal dorsal incision. First follow-up was done after second week, at this time stitches were removed and slab was discontinued. Follow-up was done monthly for 3 months and then every 3 months for one year. Results: Among 54 patients 41 (76%) were males and 13 (14%) were females, with male to female ratio of 3:1. Among these 37 (68%) were above forty years and 17 (32%) below forty years age. Regarding the types of fractures 37 (68.5%) were transverse, 12 (22.2%) oblique and 5 (9.3%) fractures were comminuted. The modal healing time was 6-8 weeks. Regarding the range of movements after the procedure; 100% of normal ROM was attained in 27, >90% of normal in 20, 75-90% of normal in 4, 50-75% of normal in 2 and <50% of normal in one case. In respect to complications there was only one case of infection and one case of non-union. Conclusion: If properly selected and timely managed excellent results can be achieved in phalangeal and metacarpal fractures with the simple procedure of k-wire fixation with a minimal dorsal incision.